Stretcher for fluoroscopy



Patented Aug. 18, 1925..

OFFICE.

r #HERMAN "a. rmnrrs, or NEW You, H. Y.

F srnn'ronnnron rnuonoscor z. Y

To all {that/concern: I

a citizen of'the United States,residing at New York jcity,"borough ofManhattan, in the county of New York and State of New York, haveinvented certain new and useful Improvements "in Stretchers .forlFluoroscopy, of which the'following is a specification. i l a This,invention relates to hospital apparatus or surgical appliances and hasparticular reference to mechanisms or apparatus for the reduction, ofbroken bones and the detection or correction of anymalposition ordeformity incident to such cases.

Among the objects of the invention is to provide a combined fracturestretcher and table designed to reducedeformities or malposition offragments of broken bones under fluoroscopic guidance,-both inhorizontal andvertical planes, and either alone or simultaneously; toafford means for traction on any limb or extremity at any angle, and

with any desired counter traction or traction or pressure at any angleto the main traction; to provide means as set forth in the foregoing toreduce deformities from fractures or disease and retain. them in andesired position while immobilizing firm y in plaster casts orsplintsjtorovidea stretcher on which a patient may e supported 'not only for thepurpose of the application oi. the traction referred to but also upon wich he'may be moved for the purpose of. fluoroscopy or radiography, butespecially to provide means whereby the observation through fluoroscopyor the making of records through the radlographic or roentgenographicsteps may be practiced at the same time that the reduction of the bonesor the like is taking place so thatthe operator maybe guided in. hisoperations by, the visual results obtained through either ofvthe meansjust referredto, and, furthermore, the stretcherlme'chaf 3 nism combinedwith the traction means in} sures that the'traction may bemaintained orpreserved irrespective of the .movement or manipulation .o tientthereon.

' to provide a stretcher having traction ape paratus associatedtherewith and, so designed as not to obstruct either the 'fiu'o'roscopi'ck vision and reducing o erations abovestretcher an f thestretcher with the' [paview the invention consists ment'and combinationof, parts hereinafter described and claimed, and whilethe invention isnot restricted to the exact details of Withheforegoing .and otherobjects in in the arrangeconstruction disclosed or suggested herein,

still for the purpose of illustrating a ractical embodiment thereofreference is ad to the accompanying drawings, in which like referencecharacters designate the same parts in the several views, and in which-Figure 1 is a side elevation showing one adaptation of my improvement.

Flg. 2 is a plan view of the same.

Fig. 3 is a sectional detail on the line 3-3 of Fig. 1.

Fig. 4 is a plan view of a detail described in connections with Fig. 5.

Fig. 5 is a vertical detail partly in section of the crotch mechanism.

Fig. 6 is a detail perspective view of the transformer mechanlsm for thehorizontal fluoroscopy, its means of support, and the vertical andhorizontal screens carried thereby.

Referring now more specificall to the drawings I show a frame or stretcer comprising two side bars 10, two end bars 11, and corner connections12. These corner pieces may constitute or carry handles 13 ormanipulating the stretcher as such, in a well known manner. The siderails 10 and either or both of the end rails are provided with verticalholes 14 spaced at re ular intervals from one another. The end rails theaccommodation of slidable rods 15 which normally telescope or may bedrawn outward to any desired length and looked as by means of a springpin 16 or its equivalent through the adjacent corner pieces for fixingthe position of the extensions. The corner pieces may have downwardextensions12' serving as feet for supporting the stretcher.

17 ndicates a plate shown assubstantiallylrect angular and extendingacross the movable endwise of the device,the endsof the plate beingturned downward around the rails. for self retention. As mdlcated portedat itsends on the side rails 10 an along which the plate 1s this plateconstitutes the main support or 7 bridge for. supporting the patients his througha disk or shelf 18 fixed adJuStab y upon the upper end' of thepedestal 19. That is to say, the disk maybe swung around the axis of thepedestal to lie either longitudinally or transversely of the stretcheraccording to its immediate puror counter traction means or bandages orslings such as indicated at 25. The disk 18 may be used as a support forthe hips as shown or may be used for other purposes such asa clamp forthe patients shoulder and for this purpose the patient may be supportedat the same level as indicated in ig. 1 or may be lowered to the planeof the stretcherframe. In the former case the disk or shelf 18 may beclamped between the crotch pin and the stem 22 or it may be otherwiseattached to the pedestal.

26 indicates a, bed plate of wood of any suitable composition and whichlike the plate. 17 is preferably transparent to Roentgen rays. The bedplate 26 istrecta'ngular and supported for endwise adjustment upon therails 10. Pillows or padding 27 will be employed for their-usual purposein bolster-' ing up the patient at any desired point.

The pedestal is connected adjustably to the plate 17 as by means ofbolts 28 co-o crating with slots 29. The plate 17 is he (1 from endwisemovement under traction on the patient along the stretcher as by meansof clamps 30 adjustable along the rails 10.

In connection with the stretcher frame or extensions thereof I employone or more traction units 31 each comprising an-arm 32 adjustablevertically in a clamp 33 carried by either end or side bar of the frame,

though usually it is connected to the foot.

rail 11 for the reduction of a broken leg. The unit includes also a nutor head 34 along wh1ch a threaded shank or screw is slidable but heldfrom rotation by any well known means such as a spline. The traction isproduced by means of a. hand wheel 36 or its equivalent co-operatingwith the threaded screw and bearing against the head 34 in a well knownmanner. The extremity, as the foot, of the patient is secured, as bybandaging or lacing, to a yoke or clamp piece 37 having universalball-joint connection in a clamp 38 fixed to the-adjacent'end of thescrew 35.

The open structure of the yoke provides for easy access to the patientsextremity for the purpose indicated. The clamp .33 may be secured to-therail eitherby means gripping the same or by means of pins passingtherethrough and through the holes 14.. For at taching the unitor any'ofthem to the frame extensions 15 a clamp 33 ma be employed. This providesan anchorage or the traction unit at an angle to the length of thestretcher for use in connection with lateral traction or for otherpurposes. As thus far described the stretcher is free and open for notonly the purposes of the traction apparatus and bandaging of the atient,but also for observation as soon to e described. Moreover, with thepatient in position on the stretcher and even with the tractionapparatus in use under tension the stretcher may be transported ormanipulated in any convenient manner.

As an illustration of the many accessories, I indicate at 39 a form ofclamp ada ted especially for connection to and interloc ing with theperforated rails of the stretcher.

Extending upward from this clamp and gripped thereto by a hand piece 40is a post 41 which obviously may be adjusted around its own axis intheclamp as may be desired. At the top of this post is a hub 42 in which isadjustably mounted a horizontal arm 43 and looked as b means of a setscrew 44. At one end of t isarm is a clamp or 'oint 45 which carries anarm 46 adjustable in any desired angle with respect to the arm 43 and inall other respects takinginto consideration themanner of connecting thearm 43 to the post, and the post in turn to the clamp 39. The arm 46 mabe provided with any suitable form of yo e 47 for use for traction,counter traction, or other'analogous urposes, and having practicallyuniversa joint connection with the main support has a 'wide range ofadjustment anywhere along the stretcher and at any position after beingso adjusted.

Another important feature of my mechanism comprises a table having a top48, corner uprights or legs 49, and a plurality of longitudinal bars notonly for stlflening the table, but for purposes soon to appear.

Some of these bars, as indicated at 50, extend lengthwise along thesides of the table approximately midway between the floor and the to 48and in the same horizontal plane. 51 indicates conventionally an X-rayapparatus or transformer mounted slidably upon a pair of transverserails 52, said rails being mountedeupon runners or shoes 53 cooperatingdirectly with the rails 50, so that the apparatus as a whole may bemoved bodily endwise of the rails 50 and also independently of the rails50 transversely of the table along the rails 52 so as to bring,

the transformer 51 beneath any point or part of the table top. Theaction of this transformer is upward or vertical through the table topand through the patient. Hence it is designed to give an image directlyupon the horizontal screen 51' or for the making of a radiograph uponaplate similarly located above the patient. I

At either side of the table is a carriage 54 comprising a pair ofvertical hollow posts 55 with any suit-able tie bars 56 between them:This carriage is mounted upon a rail 58 near the floor. The posts at anyconvenient place as just below the table top are provided with hangers59 which extend beneath the table top and carry pairs of rollers 60which embrace a bar 61 extending between the corner posts 49 of thetable. Thus the carriage 54 is movable freely along the rails 58 and 61and consequently at any .d esired position along the table from one 1longitudinally of the table. This transformer is designed to .throwutheimage horizontally where it may be observed on the vertical screen 62 ora plate may be made at such position for a radiograph. As shown in Fig.6 the screens are connected to a frame 65 slidable horizontally in guideways 66 at the top of the transformer 62 so that the screen 51 may bemoved directly over the transformer 62. The screen 62 is hinged at 67 tothe other screen or its frame and may be swung upward into the sameplaneas the screen 51 where it may be locked by spring catches 68 ortheir equivalent. With the two screens adjusted as shown in Fig.6 theoperator or surgeon may observe fluoroscopically on either or both ofthe screens simultaneously the image thrown upward and horizontally fromboth of the transformers while at work upon the patient. Obviously,after the reduction has been completed the transformer 62 may be movedout of the way for the purpose of facilitating the bandaging of the'extremity. The transformer 62 is counter balanced in a well knownmanner'by the use of suspending cables 69 to the other ends of which arecounter weights 7O movable within the posts.

From the foregoing it will be appreciated that the objects aboveindicated are attained in a practical apparatus, and by means of theuniversality of the various devices and connections the extremity or anypart of the patient can be put and kept in any position, such asflexion, extension, inversion, eversion, abduction, or adduction.appreciated also that the apparatus, having reference especially to thefluoroscopic facilities, may be utilized for general diagnosis, as forthe localization of any foreign body or particles that may seem to Itwill be.

be present in the body, and independently of reduction of fractures.

I claim:

1. The combination with a main support having a plurality of cornerposts, of a stretcher body consisting of a plurality-of rails, saidrails being united to each other by corner connections, said cornerconnections having downward extensions to cooperate with said cornerposts to retain said stretcher body in predetermined position thereon,said corner connectionshaving handles extending along the .plane of thestretcher and outwardly thereof whereby said stretcher may be liftedfrom said support while a patient reposes thereon.

2. In a stretcher of the character set forth, the combination of a frameincluding side and end rails, traction means secured to one of saidrails, and counter traction devices including a plate adjustabletransversely of the side rails and an engagement member for the patientprojecting upward from and having rigid connection with the plateadjustable clamping devices being provided co-operating with the siderails and said plates for supporting and holding the plate in adjustedposition for resisting the traction and to permit the plate to be movedtransversely of the rails as'aforesaid.

stretcher rails, and an accessory for additional traction orcountertraction, said accessory comprising a clamp adjustable along oneof the rails, an upright support connected thereto, an arm movablyconnected to said support, and a yoke having universal connection withsaid arm.

4. In a device as set forth, the combination with a stretcher havingside rails and traction means adapted to act at an angle to thestretcher, of a rod located at an end of the stretcher and slidabletransversely relative thereto within a rail thereof and beyond the sideof the stretcher, and means borne upon the railsv co-operating with therod to hold it adjustably in position as aforesaid,

said rod being adapted to adjustably engage said traction means alongthe length there- .of for the purpose of the angular traction aforesaid.p

5. The herein described counter traction devices for stretchers, thesame comprising

